Synthetic Cranioplasty Is Superior to Autologous Cranioplasty

Background: Decompressive craniectomy (DC) is often performed to manage acutely raised intracranial pressure in a variety of settings, including traumatic brain injury (TBI) and stroke. Cranioplasty is performed at some point following DC. Objective: To study long-term outcomes following cranioplasty, especially complications and incidences of repeat surgery. Design: Retrospective multicenter study. Methods: Patients from Sweden who underwent DC for a variety of reasons between 2008 and 2022 were included. The study represents 72% of all DC cases in the entire Swedish population. Data collected included patient demographics, details of DC surgery and cranioplasty, incidence of complications including reoperations, bone resorption, infection, and cerebrospinal fluid (CSF) shunt rates. Long-term follow-up and functional outcome using the modified Rankin scale (mRS) is provided. Results: 725 patients were included; 499 were males with a median age of 49 (range, 0 to 80) years. Etiology more...